This invention relates in general to surgical instruments and in particular to a surgical retractor for manipulating organs and other body tissue, as well as ligatures and surgical instruments, during laparoscopic. arthroscopic, and other similar surgical procedures.
Laparoscopic surgery is a relatively new operating technique which is much less invasive than conventional surgery and, therefore, may be performed using only a local anesthetic. Such laparoscopic surgery typically involves puncturing the abdominal wall and introducing an inert gas within the abdomen. The introduction of the inert gas expands the abdomen to facilitate access to the body parts requiring surgery and visual observation of the procedure. A hollow cylindrical tube, known as a cannula, is inserted into the puncture and is subsequently used as a conduit through which one or more elongated surgical instruments may be inserted within the abdomen. One type of surgical instrument which may be inserted through such a cannula is a surgical retractor. A surgical retractor is used to manipulate organs of other body tissue within the surgical site, either to move the body tissue out of the way of the surgeon, or to position the body tissue to a position required for the surgical procedure. Movement of a surgical retractor extending through a cannula is necessarily restricted by the relatively small diameter of the cannula and it may not be possible to cover the entire surgical site through a single cannula. If desired, a plurality of punctures may be formed through the abdominal wall to facilitate the use of several surgical retractors at various required locations about the surgical site.
However, the use of small punctures to introduce cannulas results in a great reduction in tissue trauma associated with gaining access to the surgical site as compared to traditional open surgical techniques. However, abdominal wall blood vessels may be injured and cause significant bleeding during the puncturing of the abdominal wall to insert a cannula, since even small diameter cannulas are of a relatively large diameter compared to a blood vessel in order to accommodate the typical surgical retractor of the past. For this reason, and to minimize overall surgical trauma, surgeons try to limit the number of cannulas used during surgery, and thus may attempt to operate a retractor from an awkward position rather than introduce a cannula to a new location, with the attendant risks and additional trauma. Thus, it would be desirable to provide an improved surgical retraction instrument for in laparoscopic surgical procedures which do not require insertion through a large diameter cannula.